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OBAT ANT HIPERTENSI

Sites of action of the major classes of antihypertensive drugsPenggolongan antiHT berdasarkan tempat kerjanya Sistem Saraf Simpatis di :Sentral (CNS) : clonidin, methyldopaGanglion : heksamethonium, trimethapanUjung saraf : reserpin, guanethidinReseptor adrenergik : Prazosin(1 blocker), Propanolol ( blocker), atenolol (1 blocker)Ginjal : Diuretik Otot polos vaskuler : CCB, Vasodilator RAAS : ACE inhibitor, ARB, Direct Renin InhibitorDIURETIKThiazide Hidrochlorothiazide (HCT), ChlorothalidoneLoop diureticsFurosemide, Torsemide, BumetanideDiuretik Hemat K+Amiloride, Triamterene, Spironolacton

Mekanisme kerjaAda 3 kelas diuretik utk HT

Diuretik

DIURETIKMekanisme kerja :- ekskresi Na & H2O Efek pd CVS :- akut : COP - kronik : TPR ,COP N KI :hypersensitivity, compromised kidney function, Tx cardiac glycosides (K+ effects), hypovolemia,hyponatremia

ES :- dizziness, - electrolit imbalance- hypokalemia, - hyperlipidemia,- hyperglycemi(Thiazid)- gout Sympatholitics Agents

Blok Adrenergik di CNS(CNS agents)Site of action : CNS medullary , cardiovasc centersMekanisme kerja : - agonis R/ -2 di CNS : Clonidine, Guanabenz, GuanfacineAktivasi R/-2 di medulla NE release dr SSP peripheral sympathetic activity vasc tone vasodilation TPR . - membentuk neurotransmiter palsu : Methyldopa ES : dry mouth, sedasi, impotence KI : mental depressionNOT 1st line drug, Prolong used retensi Na & air sering digunakan bersama diuretic stop mendadak rebound SymNS TD Methlydopa : DOC in pregnancyMekanisme KerjaClonidin dan Methyldopa

Blok Adrenergik di Ganglion OtonomContoh : Hexamethonium Mekanisme kerja : memblok reseptor nikotinik di ganglionBlok Adrenergik di Ujung Saraf Contoh : Reserpin, GuanethidinMekanisme kerja : - menghambat transport NE ke vesikel sinap : reserpin - mengosongkan dan memblok pelepasan NE dari tempat penyimpanannya : guanethidininhibit uptake of NE into storage vesicle (also DA, 5-HT) leads to depletion of transmitter stores (peripheral & CNS action)ES: sedation, mental depression, Parkinsonism, gastric acid secretion ulcer

Katzung 9th edBlok Adrenergik di Reseptor Adrenergik

Blok Adrenergik di Reseptor - 1 Contoh : Prazosin, Oxazosin, TerazosinSite of action : otot polos vaskuler perifer

Mekanisme kerja : memblok reseptor -1 relaksasi otot polos vaskulerdilatasi vaskulerresistensi vaskuler .Efek pd COP